Effect of cavity margin shavings to ensure completeness of excision on local recurrence rates following breast conserving surgery

Background: Breast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We conducted a meta-analysis to evaluate the local recurrence rates in locally advanced breast cancer (LABC) patients receiving NCT comparing BCS with mastectomy. Methods: Pubmed, Web of Knowledge, and Ovid's database were searched for studies concerning treatment for LABC from January 2000 to June 2015. A meta-analysis was performed to compare the recurrence rates of patients receiving BCS versus mastectomy following NCT. Results: 8 trials with a total of 3,215 patients were analyzed. The prevalence of local recurrence was 9.2% in the BCS group versus 8.3% in the mastectomy group without significant difference (odds ratio (OR) 1.07, 95% confidence interval (CI) 0.28-1.48; p = 0.66). The 5-year local recurrence-free survival (LRFS) rate was lower in the mastectomy group than in the BCS group, but no significant difference was found between the 2 groups (OR 1.11, 95% CI 0.61-1.99; p = 0.74). Conclusion: BCS after NCT is safe in terms of local recurrence and LRFS in LABC women. Shrinking tumors with NCT provides the opportunity to apply BCS with no detriment to outcome.

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229 ORAL Breast conserving surgery (BCS) after preoperative chemotherapy is not associated with higher local recurrence rates or worse overall survival compared to BCS before postoperative chemotherapy; data from the EORTC 10902 trial

European Journal of Surgical Oncology ◽

10.1016/s0748-7983(06)70664-3 ◽

2006 ◽

Vol 32 ◽

pp. S68

Author(s):

J. van Nes ◽

H. Putter ◽

C. van de Velde

Keyword(s):

Overall Survival ◽

Local Recurrence ◽

Preoperative Chemotherapy ◽

Breast Conserving Surgery ◽

Postoperative Chemotherapy ◽

Recurrence Rates

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0053 Local recurrence rates after breast conserving surgery according to age, location, ER, PR and HER status

The Breast ◽

10.1016/s0960-9776(09)70098-0 ◽

2009 ◽

Vol 18 ◽

pp. S31

Author(s):

V. Ostapenko ◽

S. Bruzas ◽

A. Mudenas ◽

J. Sabonis ◽

J. Kurtinaits ◽

...

Keyword(s):

Local Recurrence ◽

Breast Conserving Surgery ◽

Recurrence Rates

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Oncoplastic breast-conserving surgery offers low local recurrence rates and excellent survival rates despite worse tumor characteristics

European Journal of Cancer ◽

10.1016/s0959-8049(20)30595-5 ◽

2020 ◽

Vol 138 ◽

pp. S28-S29

Author(s):

C. André ◽

C. Holsti ◽

A. Svenner ◽

I. Oikonomou ◽

H.Ikonomidis Sackey ◽

...

Keyword(s):

Local Recurrence ◽

Survival Rates ◽

Breast Conserving Surgery ◽

Tumor Characteristics ◽

Recurrence Rates

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A direct comparison of surgical and non-surgical management of close anterior margins on local recurrence rates in breast conserving surgery

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.02.120 ◽

2016 ◽

Vol 42 (5) ◽

pp. S30

Author(s):

George Boundouki ◽

Joseph R.W.S. Hee ◽

Natalie Croghan ◽

Critchley Adam ◽

Cliona C. Kirwan ◽

...

Keyword(s):

Local Recurrence ◽

Surgical Management ◽

Breast Conserving Surgery ◽

Recurrence Rates

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Over view of clinical presentation, management and outcome of cervical cancer: A tertiary cancer centre experience

10.1055/s-0039-1685265 ◽

2016 ◽

Author(s):

H. Shukla ◽

K. Batra ◽

R. Sekhon ◽

S. Giri ◽

S. Rawal

Keyword(s):

Cervical Cancer ◽

Local Recurrence ◽

Radical Hysterectomy ◽

Gynecological Cancer ◽

Age Group ◽

Recurrence Rates ◽

Oncological Safety ◽

Robotic Radical Hysterectomy ◽

Time Period ◽

Hospital Registry

Objectives: (a) To understand the profile of cervical cancer patients attending our hospital from January 2011 till January 2015. (b) To audit the type of care given to the patients with respect to their stage at presentation. (c) To compare the outcomes of open v/s robotic radical hysterectomy done for cervical cancer. Methods: We prospectively analyzed all cases of cervical cancer from January 2011 to January 2015 presenting at our institute. Data was retrieved from patient’s records and institute’s tumor registry. We compared all patients undergoing open v/s robotic RH. All the data were analysed using SPSS version 21. Results: A total of 562 patients were treated for cervical cancer during the time period between 2011-2015. Of these there were 316 (56%) cases taken up for surgery-212 robotic RH, 104 open radical hysterectomy and rest 246 (44%) patients received definitive CCRT. Most common age group was 40-54 yrs. IB1 stage was most common presenting stage. SCC was most common histology (75%). Immediate post op complication and oncological safety in terms of local recurrence was same in both groups. However length of stay and post operative blood requirement was significantly lower in robotic RH group. 45% of all patients who underwent surgery did not require adjuvant therapy in post op period while 35% patient required post op RT and 20% CCRT. 2.2% patient had local recurrence and most of the patients were in stage IIA1 at presentation. Conclusion: Cervical cancer is the most common gynecological cancer in our hospital registry. Mostly women were in the age group of 40-54 years. Most common stage at presentation was 1B and the histology being SCC. Not many differences seen in open v/s robotic techniques of radical hysterectomy except for shorter hospital stay and less need of blood transfusion in the robotic group. Local recurrence rates are comparable in both open and robotic groups.

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Radiation-Associated Angiosarcoma of the Breast and Chest Wall Treated with Thermography-Controlled, Contactless wIRA-Hyperthermia and Hypofractionated Re-Irradiation

Cancers ◽

10.3390/cancers13153911 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3911

Author(s):

Markus Notter ◽

Emanuel Stutz ◽

Andreas R. Thomsen ◽

Peter Vaupel

Keyword(s):

Local Recurrence ◽

Background Radiation ◽

Definitive Treatment ◽

Resection Margins ◽

Recurrence Rates ◽

Rate Dependent ◽

Angiosarcoma Of The Breast ◽

Positive Resection Margins ◽

Locally Recurrent ◽

Tumor Extent

Background: Radiation-associated angiosarcoma of the breast (RAASB) is a rare, challenging disease, with surgery being the accepted basic therapeutic approach. In contrast, the role of adjuvant and systemic therapies is a subject of some controversy. Local recurrence rates reported in the literature are mostly heterogeneous and are highly dependent on the extent of surgery. In cases of locally recurrent or unresectable RAASB, prognosis is very poor. Methods: We retrospectively report on 10 consecutive RAASB patients, most of them presenting with locally recurrent or unresectable RAASB, which were treated with thermography-controlled water-filtered infrared-A (wIRA) superficial hyperthermia (HT) immediately followed by re-irradiation (re-RT). Patients with RAASB were graded based on their tumor extent before onset of radiotherapy (RT). Results: We recorded a local control (LC) rate dependent on tumor extent ranging from a high LC rate of 100% (two of two patients) in the adjuvant setting with an R0 or R2 resection to a limited LC rate of 33% (one of three patients) in patients with inoperable, macroscopic tumor lesions. Conclusion: Combined HT and re-RT should be considered as an option (a) for adjuvant treatment of RAASB, especially in cases with positive resection margins and after surgery of local recurrence (LR), and (b) for definitive treatment of unresectable RAASB.

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Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316293 ◽

2020 ◽

pp. bjophthalmol-2020-316293

Author(s):

Puneet Jain ◽

Paul T Finger ◽

Maria Fili ◽

Bertil Damato ◽

Sarah E Coupland ◽

...

Keyword(s):

Local Recurrence ◽

Local Excision ◽

External Beam Radiotherapy ◽

Staging System ◽

Primary Treatment ◽

Excision Biopsy ◽

Conjunctival Melanoma ◽

Recurrence Rates ◽

Increased Risk ◽

Eighth Edition

BackgroundTo relate conjunctival melanoma characteristics to local control.MethodsRetrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.Results288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence.ConclusionThis multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.

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